{template header.html}
<form action="" method="post" name="myform" id="myform">
    <input name="page" id="page" type="hidden" value="{$page}" />
    <div class="subnav">
        <div class="content-menu ib-a blue line-x">
            {$menu}
        </div>
        <div class="bk10"></div>
        <fieldset>
            <legend>{fc_lang('录入/查看转账')}</legend>
            <table width="100%" class="table_form">
                <tbody>
                <tr>
                    <th width="200">* {fc_lang('订单号')}</th>
                    <td>
                        <input class="input-text" type="text" name="data[sn]" value="{$sn}" style="width:70%;">
                    </td>
                </tr>
                <tr>
                    <th width="200">* {fc_lang('银行名称')}</th>
                    <td>
                        <input class="input-text" type="text" name="data[bank_name]" value="{$data[bank_name]}" style="width:70%;">
                    </td>
                </tr>
                <tr>
                    <th width="200">* {fc_lang('银行卡号')}</th>
                    <td>
                        <input class="input-text" type="text" name="data[bank_sn]" value="{$data[bank_sn]}" style="width:70%;">
                    </td>
                </tr>
                <tr class="dr_border_none">
                    <th>{fc_lang('备注说明')}</th>
                    <td>
                        <textarea name="data[note]" style="width:80%; height:200px;margin-top:10px;">{$data[note]}</textarea>
                    </td>
                </tr>
                <tr class="dr_border_none">
                    <th>{fc_lang('转账凭证图片')}</th>
                    <td>
                        {dr_field_input('bank_note', 'File', $field['bank_note']['setting'], $data['bank_note'])}
                    </td>
                </tr>

                </tbody>
            </table>
        </fieldset>
    </div>
    <div class="fixed-bottom">
        <div class="fixed-but text-c">
            <div class="button"><input value="{fc_lang('提交')}" type="submit" name="submit" class="cu" style="width:100px;" /></div>
        </div>
    </div>
</form>
{template footer.html}